Home
  
/  Massachusetts' Private Family and Medical Leave (MA PFML) with USAble Life

Massachusetts' Private Family and Medical Leave (MA PFML) with USAble Life

FAQ

FAQ

Q. What are the potential benefits of providing the MA PFML benefits through the USAble Life private plan?
A.
USAble Life believes that private-plan administration is ideal because it will:

  • Provide your employees with an experience better than having to apply for benefits through the state-run program, including quicker administration, easier-to-navigate claims processes, and superior claim transparency
  • Ensure appropriate claim review and decision-making with experienced staff
  • Enable you, as an employer, to deduct differing percentages from the employee’s wages provided you do not deduct more than the maximum percentages authorized under the law
  • Offer different benefits for different classes of employees provided you meet or exceed the state plan benefits for all classes

Q. Who is eligible for the USAble Life MA PFML?
A.
Employers with 25 or more employees are eligible for USAble Life’s MA PFML Compliant Plan and require custom underwriting quoting.

Q. Will USAble Life allow an employer to cover medical only or family only with their private option?
A.
No, USAble Life will only offer plans that cover both medical and family benefits. USAble Life believes that the claim experience will suffer if one part of MA PFML is covered through a private option and the other through the state plan.

For example, someone is on medical leave due to pregnancy bed rest then transitions to family leave after the birth of a child. Due to the combined maximum of 26 weeks and the strong potential that employees may have both medical and family leaves in a benefit year, it is not advantageous for an employer to cover medical and family leave through two different organizations.

Q. What options do employers have if we want to provide benefits that are more generous than the statutory minimum benefits?
A.
Several options are available with USAble Life that provide better than statutory benefits:

  • Protect employees with a MA PFML policy that has a higher maximum benefit than the statutory benefit. For example, a plan can be established with a maximum benefit of up to $1,500 higher than the statutory maximum.
  • Protect high earners with a Short Term Disability (STD) plan that coordinates with and offsets the MA PFML medical benefit.
  • Protect employees outside of Massachusetts (MA) with the same MA PFML plan as MA employees or with a standard STD plan.
  • Employers can contribute more than outlined in the statute to remove some or all of the burden of payroll deductions.

Q. Should employers cancel their disability insurance policies or programs?
A.
No, medical leave and STD are not the same. STD will continue to be a valuable employee benefit.

1. Benefit amount for high-income employees – due to the MA PFML weekly benefit, employers with high earners will need additional coverage for their employees.

2. Consequences of the interdependency of family and medical leave allotments – under the MA PFML, there is a combined and interdependent entitlement of family and medical leave. If an employee takes 12 weeks of family leave in a benefit year, the employee will only be eligible for 14 weeks of medical leave under the MA PFML. If the employer has a 26-week elimination period before long-term disability benefits are payable and cancels STD coverage, the employee may be left without income replacement for 12 weeks if the leave qualifies as a disability under an STD provision.

3. Impact of intermittent leave – MA PFML can be taken intermittently so an employee may substantially reduce and/or exhaust MA PFML entitlement and be left without income replacement protection if they become seriously and continuously disabled thereafter.

4. The maximum duration of MA PFML medical leave is 20 weeks. In some cases, this leaves a gap between MA PFML and an STD with a 26-week duration. Employers will want to ensure their employees are fully covered in the event of a longer-term disability.

5. STD policies provide features and benefits the MA PFML program cannot.

Q. If we provide better-than-statutory benefits for MA PFML, how do we handle the employee contributions?
A.
Premiums for benefits for MA employees up to the maximum can have both employee- and employer-paid contributions as outlined in the statute. Any premiums for benefits offered above the MA PFML maximum or for non-statutory employees outside of MA must be 100% employer-paid.

Q. How will MA PFML interact with USAble Life’s STD benefits?
A.
USAble Life will offset the amount of the MA PFML benefit against the STD benefit in circumstances where the employee is eligible for both MA PFML and STD.

We will reduce the STD rates accordingly based on the MA PFML offset when the STD is offered along with MA PFML.

Example:

A high-earning employee has a medical situation and is temporarily disabled for 26 weeks in accordance with the contract provisions of both MA PFML and STD. Assumptions:

1. They have a salary that warrants a total $1,250 weekly from their STD benefit, and they reach the maximum of $850 weekly from MA PFML benefit

2. STD elimination period (EP) is 14 days

3. STD plan has a 26-week duration

Q. Will we have to complete a new employer application with USAble Life?
A.
Yes, since the MA PFML is a different product and certificate, a new employer application will be required.

Q. If offering STD benefits in addition to MA PMFL, what is USAble Life’s guidance on duration?

A. When covering employees under both the MA PFML and STD, USAble Life recommends offering the STD plan with a 26-week duration to match the MA PFML 26-week duration maximum.

Q. How does a claim work if someone is on bed rest (medical) and then gives birth (family)?
A.
This is likely a common scenario where a MA PFML medical leave will convert to family leave. As long as the required claim information is submitted and the initial elimination period has been met, the benefit payment will be continuous through the medical and family claim up to the 26-week maximum duration allowed in a benefit year.

Q. What happens if I cover non-statutory employees outside of MA, and their state also has a statutory PFML program?
A.
Other state or federal statutory benefits are subject to offsets under the MA PMFL contract.

Q. Can former employees obtain MA PFML benefits?
A.
Yes. An employee continues to be eligible for MA PFML benefits if the employee has been separated from employment for not more than 26 weeks at the start of the leave.